From spacesuits to hiking boots, it's time for gendered innovation

Sex and gender impact every aspect of our lives and it is more than spacesuits not fitting female astronauts — what recently cost NASA a historic all-women spacewalk.

We see the impact from the shoes and clothing we wear, the electronic devices we use, the cars we drive in, and even the medications we take. The "pink it-shrink it' approach for gendered innovation will never work in any environment including space, battlefields, hot zones and our homes. 

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In my capacity as the senior medical advisor to NASA for over 18 years, I chaired two decadal reviews assessing the impact of gender/sex on adaptation to space, working with scientists and clinicians from within the space agency and academia. Space is an extraordinary platform to study sex/gender differences since small changes can have monumental impact on well-being and performance. Every system in the body changes in the microcosm of space.

In 2014, the second decadal review was published in the Journal of Women's Health. In it, it was noted that there was progress on several fronts including assessments of the design of new spacesuits based on anthropometric measurements and movement in which sex can have an impact — it was much more than size. This was an optimistic development that spacesuit limitations, which astronauts especially female astronauts, endured for over 40 years would finally be addressed. 

In early 2017, NASA supported a challenge competition to assess the impact of sex and gender on innovation and technologies. Ironically, the winning submission by a NASA engineer focused on a modular space suit design which took into account sex differences as the body adapts in space.

Unfortunately, leadership priorities compounded by financial constraints have hampered spacesuit development over many years. Perhaps, the recent heightened focus on spacesuit issues for female astronauts will finally catalyze efforts to advance new product designs not only for the grandeur of space but for all environments.

Human factors or social determinants of health play an important role in how we live our lives. For example, boots including military and athletic, are not designed for how a woman walks. Female patients experience repetitive stress injuries from using their electronic devices that don't register their touch, serious neck injuries sustained during car accidents from restraints which don't fit their heads and necks, and side effects from taking medications which are not tested in women. 

During a recent roundtable hosted by my organization, iGIANT, on space and extreme environments, it was disheartening to hear from one our nation's top female fighter pilots that she experienced emotional, physical and spiritual harm trying to do her job. She said she wasted much time retrofitting her equipment to accomplish this feat. In over 60 roundtables since 2017, countless stories have been shared by women and men about how a "one side-fits-all” approach for design elements such as products, programs, protocols and policies does not work. It's time to find solutions to address these issues. 

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It's time for all federal agencies to ensure that their programs and policies have a focus on inclusion and diversity for basic, clinical and applied research to operations. Additionally, inclusion and diversity efforts transcend human resource departments. All offices within the agencies such as education, community outreach, research, medical, and engineering need to be involved. Therefore, there should be a centralized entity within each agency to coordinate these efforts. 

It's time for the private sector to also evaluate their design elements to determine that they meet the needs of all customers and clients. If companies can receive recognition for these efforts, they may not only find commercial value, but also advancement in human capital. 

It's time to see the world through a gender/sex lens. When we achieve this goal, we are taking a major leap toward mission success for everyone — that can improve space exploration and our daily lives on Earth. 

Dr. Saralyn Mark is the former senior medical advisor for NASA. Mark is also the founder president iGIANT, a non-profit organization dedicated to improving the safety and quality of life for men and women by accelerating the translation of research.